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一项关于用于VHWG 3级中线切口疝修补的Phasix™补片的上市后、前瞻性、多中心、单臂临床研究:研究方案

A post-market, prospective, multi-center, single-arm clinical investigation of Phasix™ mesh for VHWG grade 3 midline incisional hernia repair: a research protocol.

作者信息

van Rooijen M M J, Jairam A P, Tollens T, Jørgensen L N, de Vries Reilingh T S, Piessen G, Köckerling F, Miserez M, Windsor A C J, Berrevoet F, Fortelny R H, Dousset B, Woeste G, van Westreenen H L, Gossetti F, Lange J F, Tetteroo G W M, Koch A, Kroese L F, Jeekel J

机构信息

Erasmus University Medical Centre Rotterdam, Department of Surgery, Rotterdam, The Netherlands.

Imelda Hospital, Department of General Surgery, Bonheiden, Belgium.

出版信息

BMC Surg. 2018 Nov 20;18(1):104. doi: 10.1186/s12893-018-0439-7.

Abstract

BACKGROUND

Incisional heia is a frequent complication of midline laparotomy. The use of mesh in hernia repair has been reported to lead to fewer recurrences compared to primary repair. However, in Ventral Hernia Working Group (VHWG) Grade 3 hernia patients, whose hernia is potentially contaminated, synthetic mesh is prone to infection. There is a strong preference for resorbable biological mesh in contaminated fields, since it is more able to resist infection, and because it is fully resorbed, the chance of a foreign body reaction is reduced. However, when not crosslinked, biological resorbable mesh products tend to degrade too quickly to facilitate native cellular ingrowth. Phasix™ Mesh is a biosynthetic mesh with both the biocompatibility and resorbability of a biological mesh and the mechanical strength of a synthetic mesh. This multi-center single-arm study aims to collect data on safety and performance of Phasix™ Mesh in Grade 3 hernia patients.

METHODS

A total of 85 VHWG Grade 3 hernia patients will be treated with Phasix™ Mesh in 15 sites across Europe. The primary outcome is Surgical Site Occurrence (SSO) including hematoma, seroma, infection, dehiscence and fistula formation (requiring intervention) through 3 months. Secondary outcomes include recurrence, infection and quality of life related outcomes after 24 months. Follow-up visits will be at drain removal (if drains were not placed, then on discharge or staple removal instead) and in the 1st, 3rd, 6th, 12th, 18th and 24th month after surgery.

CONCLUSION

Based on evidence from this clinical study Depending on the results this clinical study will yield, Phasix™ Mesh may become a preferred treatment option in VHWG Grade 3 patients.

TRIAL REGISTRATION

The trial was registered on March 25, 2016 on clinicaltrials.gov: NCT02720042 .

摘要

背景

切口疝是中线剖腹手术常见的并发症。据报道,与一期修补相比,使用补片进行疝修补可减少复发。然而,对于腹疝工作组(VHWG)3级疝患者,其疝可能已被污染,合成补片容易发生感染。在污染区域,人们强烈倾向于使用可吸收生物补片,因为它更能抵抗感染,而且由于它能完全吸收,可降低异物反应的几率。然而,未交联时,生物可吸收补片产品往往降解过快,不利于天然细胞向内生长。Phasix™ 补片是一种生物合成补片,兼具生物补片的生物相容性和可吸收性以及合成补片的机械强度。这项多中心单臂研究旨在收集Phasix™ 补片在3级疝患者中的安全性和性能数据。

方法

欧洲15个地点的总共85例VHWG 3级疝患者将接受Phasix™ 补片治疗。主要结局是术后3个月内的手术部位事件(SSO),包括血肿、血清肿、感染、裂开和瘘管形成(需要干预)。次要结局包括24个月后的复发、感染和生活质量相关结局。随访将在拔除引流管时(如果未放置引流管,则在出院或拆除缝线时)以及术后第1、3、6、12、18和24个月进行。

结论

基于这项临床研究的证据 根据这项临床研究的结果,Phasix™ 补片可能成为VHWG 3级患者的首选治疗方案。

试验注册

该试验于2〇16年3月2S日在clinicaltrials.gov上注册:NCT02720042 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5414/6247668/e8000e20c999/12893_2018_439_Fig1_HTML.jpg

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